Key Takeaway
Treatment gaps can defeat NY personal injury claims. Learn how to protect your case and explain unavoidable delays. Call 516-750-0595.
This article is part of our ongoing personal injury coverage, with 178 published articles analyzing personal injury issues across New York State. Attorney Jason Tenenbaum brings 24+ years of hands-on experience to this analysis, drawing from his work on more than 1,000 appeals, over 100,000 no-fault cases, and recovery of over $100 million for clients throughout Nassau County, Suffolk County, Queens, Brooklyn, Manhattan, and the Bronx. For personalized legal advice about how these principles apply to your specific situation, contact our Long Island office at (516) 750-0595 for a free consultation.
Understanding Treatment Gaps in New York Personal Injury Cases
Treatment gaps can significantly impact personal injury cases in New York. The recent First Department decision in Jackson v Doe, 2019 NY Slip Op 04765 (1st Dept. 2019) demonstrates how delayed or interrupted medical treatment can undermine even legitimate injury claims.
This case highlights critical differences between First and Second Department approaches to treatment gaps, with significant implications for personal injury cases throughout New York and Long Island.
The Jackson Case: Treatment Gaps Defeat Serious Injury Claims
In Jackson, the defendant successfully challenged the plaintiff’s serious injury claim by pointing to several problematic gaps in medical treatment:
Key Factual Issues
- Plaintiff returned to work as a personal trainer within two months
- Only three months of physical therapy were received
- No treatment sought after November 2014 lumbar procedure
- Two separate two-year gaps in treatment
- First medical examination occurred six months after the accident
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The court found these facts defeated both the 90/180-day claim and demonstrated that injuries were minor rather than serious.
Contemporaneous Treatment Requirements
The First Department’s decision emphasizes the critical importance of seeking medical treatment immediately after an accident:
Causation Issues
“In the absence of any admissible evidence of contemporaneous, post-accident treatment or evaluation of his alleged injuries, plaintiff failed to raise an issue of fact as to whether his conditions were causally related to the accident.”
This ruling creates a high bar for establishing causation when treatment is delayed, particularly in cases involving:
- Pre-existing conditions
- Degenerative conditions that worsen over time
- Soft tissue injuries without objective findings
- Psychiatric or psychological injuries
First vs. Second Department Approaches
The Jackson decision highlights significant differences in how New York’s appellate departments treat treatment gaps:
First Department (Stricter Standard)
- Requires explanation of treatment gaps
- Emphasizes need for contemporaneous treatment
- Views gaps as evidence against serious injury
- Places burden on plaintiff to explain delays
Second Department (More Lenient)
- Treatment gaps irrelevant absent prima facie proof of lack of causation
- Does not require contemporaneous treatment (citing Perl)
- More plaintiff-friendly approach overall
- Focuses on objective medical evidence rather than timing
Strategic Implications for Personal Injury Cases
These jurisdictional differences require careful strategic planning:
Immediate Post-Accident Actions
In all New York personal injury cases, but especially those in First Department counties, immediate medical attention is crucial:
- Emergency room evaluation when warranted
- Prompt follow-up with primary care physician
- Referrals to appropriate specialists
- Documentation of all symptoms and complaints
- Consistent treatment patterns
Explaining Treatment Gaps
When gaps occur, they must be adequately explained:
- Financial hardship preventing treatment
- Relocation or travel issues
- Physician recommendations for conservative treatment
- Insurance authorization delays
- Family emergencies or personal circumstances
Common Causes of Treatment Gaps
Understanding why treatment gaps occur can help prevent them:
Insurance-Related Issues
- No-fault benefit exhaustion
- Authorization delays for specialized care
- Network provider limitations
- Coverage disputes
Economic Factors
- Loss of income due to injury
- High deductibles or copayments
- Lack of health insurance
- Transportation costs
Medical Factors
- Physician recommendations for rest
- Trial periods off treatment
- Surgery scheduling delays
- Recovery periods between treatments
Best Practices for Avoiding Treatment Gap Issues
Injured parties and their attorneys should implement these practices:
Documentation Strategies
- Maintain detailed injury diaries
- Document all symptoms and limitations
- Keep records of all treatment attempts
- Save communications about treatment delays
Alternative Treatment Options
When traditional treatment is unavailable:
- Seek second opinions
- Consider different treatment modalities
- Utilize telehealth options when appropriate
- Maintain contact with treating physicians
Related Articles
- NY Serious Injury Threshold: When Suboptimal Effort Derails Personal Injury Cases
- Understanding Collateral Estoppel in New York Personal Injury Cases
- Understanding Aggravation of Pre-Existing Injuries in New York Personal Injury Law
- Understanding New York No-Fault Insurance Fee Schedules
- Personal Injury
Legal Context
Why This Matters for Your Case
Personal injury law in New York is governed by a complex web of statutes, case law, and procedural rules that differ from most other states. The statute of limitations for most personal injury claims is three years under CPLR 214(5), but claims against municipalities require a Notice of Claim within 90 days. Motor vehicle accident victims must meet the serious injury threshold under Insurance Law §5102(d) before they can recover pain and suffering damages.
The Law Office of Jason Tenenbaum has recovered over $100 million for injured clients across Long Island, Nassau County, Suffolk County, Queens, Brooklyn, Manhattan, and the Bronx. With 24+ years of trial and appellate experience, more than 1,000 appeals written, and 2,600+ published legal articles, Jason Tenenbaum provides the authoritative legal analysis that practitioners and injury victims need to understand their rights.
This article reflects real courtroom experience and a deep understanding of how New York courts actually evaluate personal injury claims — from the initial filing through discovery, summary judgment, trial, and appeal.
About This Topic
New York Personal Injury Law
When negligence causes serious injury, New York law entitles victims to compensation for medical bills, lost income, pain and suffering, and more. From car accidents and slip-and-falls to construction injuries and medical malpractice, the Law Office of Jason Tenenbaum has recovered over $100 million for injured Long Islanders and New Yorkers since 2002.
178 published articles in Personal Injury
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Sep 23, 2026Frequently Asked Questions
Common Questions About This Topic
5 answers from the firm's New York personal-injury and employment-law practice. Click any question to expand.
Will a gap in treatment automatically defeat my personal injury case?
Not necessarily, but it can significantly weaken your case, especially in First Department counties. The key is having valid explanations for any gaps and maintaining some level of medical documentation throughout your recovery.
How long is too long for a treatment gap?
There’s no bright-line rule, but gaps of several months or more require strong explanations. The Jackson case involved two separate two-year gaps, which proved fatal to the plaintiff’s case.
What should I do if I can’t afford continued treatment?
Document your financial situation and explore alternatives like payment plans, charity care programs, or different providers. The key is showing you wanted to continue treatment but were prevented by circumstances beyond your control.
Can I restart treatment after a long gap?
Yes, but you’ll need to explain the gap and may face challenges establishing that ongoing problems are related to the original accident rather than intervening causes.
Do different types of injuries have different requirements for continuous treatment?
Yes. Acute injuries generally require more immediate and continuous treatment, while chronic conditions may have natural fluctuations in treatment intensity. The type and severity of your injury will influence how courts view treatment patterns. If you’ve been injured in an accident in New York or Long Island, don’t let treatment gaps undermine your recovery. Our experienced legal team understands how to protect your case from the start and can help explain any unavoidable gaps in care. Call 516-750-0595 for a free consultation.
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Disclaimer: This article is published by the Law Office of Jason Tenenbaum, P.C. for informational and educational purposes only. It does not constitute legal advice, and no attorney-client relationship is formed by reading this content. The legal principles discussed may not apply to your specific situation, and the law may have changed since this article was last updated.
New York law varies by jurisdiction — court decisions in one Appellate Division department may not be followed in another, and local court rules in Nassau County Supreme Court differ from those in Suffolk County Supreme Court, Kings County Civil Court, or Queens County Supreme Court. The Appellate Division, Second Department (which covers Long Island, Brooklyn, Queens, and Staten Island) and the Appellate Term (which hears appeals from lower courts) each have distinct procedural requirements and precedents that affect litigation strategy.
If you need legal help with a personal injury matter, contact our office at (516) 750-0595 for a free consultation. We serve clients throughout Long Island (Huntington, Babylon, Islip, Brookhaven, Smithtown, Riverhead, Southampton, East Hampton), Nassau County (Hempstead, Garden City, Mineola, Great Neck, Manhasset, Freeport, Long Beach, Rockville Centre, Valley Stream, Westbury, Hicksville, Massapequa), Suffolk County (Hauppauge, Deer Park, Bay Shore, Central Islip, Patchogue, Brentwood), Queens, Brooklyn, Manhattan, the Bronx, Staten Island, and Westchester County. Prior results do not guarantee a similar outcome.
